Provider Demographics
NPI:1568546976
Name:SAYRE-CARSTAIRS, LYNN CAROL (DMD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:CAROL
Last Name:SAYRE-CARSTAIRS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 CALIFORNIA BLVD STE L
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2545
Mailing Address - Country:US
Mailing Address - Phone:805-545-9400
Mailing Address - Fax:805-545-8336
Practice Address - Street 1:620 CALIFORNIA BLVD STE L
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2545
Practice Address - Country:US
Practice Address - Phone:805-545-9400
Practice Address - Fax:805-545-8336
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA364581223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics